Recent decades have seen a significant growth of basic, clinical, and epidemiologic investigation into the problem of teratogenesis due to environmental and external factors. With the realization that teratogens are an important cause of many serious and common abnormalities in neonates and children, has come an emphasis by health care agencies on preventing teratogenic exposure. Unfortunately, the goal of primary prevention through the avoidance of hazardous prenatal exposures remains substantially unrealized.
The striking proliferation of both therapeutic agents and chemical sources of pollution of our environment, coupled with self-medication and use of other chemical agents and non-therapeutic drugs by pregnant women makes drugs the most common cause of teratogenesis. Some reports suggest that the average pregnant women takes four or more medications, both prescribed and non-prescribed, during gestation. Among the drugs that are habitually used and abused, ethanol, tobacco and cocaine present the most significant public health problems.
There has been increasing concern about the effects of ethanol on the developing fetus. Ethanol is known to cross the placenta and cause deleterious effects on the developing fetus. Indeed, as little as 30 ml (1 ounce) of ethanol per day increases the risk of decreased birth weight; even moderate drinking may be responsible for an increased risk of spontaneous abortion (See, S. E. Hyman and N. H. Cassem, "13. III. Alcoholism," in D. C. Dale and D. D. Federman (eds.), Medicine, Scientific American, New York, page 11 1995!); and Council on Scientific Affairs, J. Amer. Med. Assoc., 249:2517 1983!).